Psychotherapist—A New Kind of Person

When something new happens, it must instantly begin to grapple with what used to be.  The new only very gradually replaces the old, and with a lot of struggling.  So it is with being a psychotherapist, liberally confused with a number of social roles, including parent, friend, lover and doctor—all of which contribute pieces to a psychotherapist’s identity, but cannot by themselves, represent it.  As with all new things, we must discover what and who it is.

All psychotherapists are, at least to some extent confused about who they are, whether they admit it to themselves or not.  Most are impatient on the uneven course of discovery, and jump the gun into one of the various roles that a psychotherapist imitates.  They become friends with their patient, or argue about what’s right or wrong about the patient—sometimes with shouting—as one might do with their real adolescent child.  Occasionally they have a sexual affair with their patient.

Some therapists act like doctors, meaning they keep an enormous emotional distance, never answer questions about themselves and regard diagnosis as a definition of whom they’re working with.  When diagnosis, to a very good psychotherapist, is simply a map of hints to where painful dysfunction hides, and provides clues to what interventions might expose and heal it.

So what’s different about a psychotherapist from these traditional human roles?  Perhaps the most remarkable aspect of being a successful psychotherapist—measured not by how much money they make, but how much their patients change—is the level of moral standard to which they must aspire; nothing less than squeaky-clean works.  They achieve a level of intimacy that rivals both parenting and romance yet never touch their patient unless the therapy demands it—for instance, with patients who have been severely deprived of touch and affection.  Their hugs are entirely comforting, and have nothing whatsoever to do with sex—and can easily, respectfully and gently reject a seductive patient, reminding their patient how much more valuable, and rare, a learning relationship is than a sexual one.

In the simplest formulation, a psychotherapist needs the moves of a master-caretaker, with the ethics of a monk.  Not cloistered in emotional distance, but face to face, only feet away with an attractive man or woman yearning for any human contact, even, and most likely of the wrong kind … until some healing can settle down such initial testing of the therapist, and move into a shared learning arrangement.

In the search for psychotherapist identity, at least a few therapists are asking the critical, what might be called philosophical question: why did fate create this unusual social role?  And what is our destiny—meaning what are we going to do with it.  What general wisdom should we glean from this advent?  What is the model of psychotherapist designed to teach all human beings?  Could it be a higher level generally of interpersonal ethics?

One thing is for certain, though some might disagree.  That in the last 100 years psychotherapy—specifically the knowledge derived from it—has significantly raised the level of parenting competence.  It’s very much like the first influx of sugar to Europe from the New World, which raised the height of the average person over a foot.  Visit a costume museum to see how small people used to be.

This rapid improvement in parenting has been achieved simply by helping us begin to understand who children really are—not at all the not-seen or heard creatures we used to expect should imitate us as grownups as quickly as possible.  If anything we’ve gone to the other extreme by promising children, with our constant clapping, they will always be stars no matter how well or what they do, leaving them secretly ashamed of having any shortcomings—need to learn—and very self-referenced in order to hide this shame.

There is another powerful consequence of making psychotherapy so central to human society, such that in a crisis we now instantly assume that people will need it.  This is the extraordinary expectation that loving should not just be felt, but also become competent in how well we care for a particular person.  That’s never happened before.  The great multiplicity of cultures may pretend that their particular version of love is the best.  But psychotherapy insists that only the individual has the right to decide whether it works for them or not.

This is an extraordinarily powerful democratic event!  Though we haven’t felt the power of it yet.  It isn’t time.  In current society the individual is significantly persona-non-grata, a distant second to the good of all.  But someday this democratic advent that psychotherapy has spawned will push us in other directions.

In its present form psychotherapy is not easily imitated anywhere—certainly not in the movies, where the popularized view of it is appropriately made fun of.  The whole idea, for instance, of treating a serious criminal (The Sopranos) is a complete corruption of what psychotherapy is about—facing the truth, whatever that may be, and divesting one’s self of false pretences.  All psychic symptoms are based upon mendacity.  Treating active criminals is like trying to work with a patient for excessive drinking who gets drunk for every session.  Such behavior makes a mockery of what it pretends to do; thereby proving once more that the world is, underneath it all, a corrupt place.  Self-learning fails utterly in the presence of deceit or lying; except the unconscious variety of mendacity, always done in childhood for the sake of others, which therapy is designed to expose and heal.

The process of psychotherapy is very mysterious; though it reveals how behavior expresses, and reveals to sensitive others, far more than the behaving person is aware of.  It influences and changes the therapist as well as the patient, though of course to a much lesser extent.  The deepest therapy is far less about the relationships we have with each other—chiefly talked-about in the shallower counseling forms of therapy—and far more about dreams and feelings and fear—in other words about our relationship to ourselves.  Psychotherapy models a far more complete and profound understanding of the self than any other human activity, including romantic love and marriage.  Indeed romance is designed not-to-see certain truths that would compromise its magic.

There is a spiritual quality to very good psychotherapy.  It treats the individual person more like a sacred object than religion has ever done, except in its rhetoric.  Everything a person feels or thinks is carefully treated, closely examined and respectfully regarded, no matter how embarrassed or guilty the patient may feel about it.  That’s why some consider the psychotherapist to be a secular priest, though one who listens instead of preaching, letting the patient’s life, and their unconscious game plan for healing provide the path to be walked upon, their experience the sermon to be studied.